Tuesday, 17 November 2015

Two-time Masters Champion Bernhard Langer
has battled the yips throughout his career. He told the Telegraph they are: "an involuntary and uncontrollable
movement of the muscles, resulting in a fast,
jerky, uncontrolled putting stroke. It is like a muscle
spasm; you hold the putter this way or that way
- it doesn't matter - and sometimes you can't take it back.
You freeze, you totally freeze - or you just jerk."
Image: Wikipedia.

A golf champion prepares for the easiest of putts on the final green, only for his wrist to jerk suddenly, sending the ball wide of the mark. A darts player pulls back his arm for a winning throw, takes aim, but finds he can't let go. Incidences like this – in which highly skilled sports players find their fine motor control has gone awry – are incredibly common (some surveys find over 50 per cent of skilled golfers have experienced it). And yet a new review published in the International Review of Sports and Exercise Psychology makes it clear that psychologists really know surprisingly little about what causes "the yips" (also known as "dartitis" in darts) or how best to intervene to help.

Philip Clarke and his colleagues trawled the sports psychology literature for relevant English language articles published between 1989 and 2013. They identified 25 papers that involved study of the yips, which the authors define as "a psycho-neuromuscular impediment affecting the execution of fine motor skills during sporting performance." Together, these studies involved 876 sports people who experienced the yips and 1003 competitors without the condition. Most of the research is on golf players, but a minority of studies have involved other sports including running, cricket, tennis and shooting.

Research conducted on the yips to date falls into three main categories: psychological research, physiological studies and neurological studies. The psychological research has focused mainly on the role of anxiety, with mixed results. Competitors' subjective accounts of the yips suggest that anxiety is key, yet studies that have compared sufferers and non-sufferers have often failed to reveal any differences in their levels of state (i.e. in the moment) or trait anxiety. There are also mixed findings regarding the role of obsessional thoughts and perfectionism, with the evidence to date suggesting that self-consciousness (i.e. the feeling of being watched) might be most relevant.

Regarding physiological research, most studies have used electromyography to record athletes' muscular activity and there's some evidence here that people who experience the yips have higher than normal muscle activity in some situations, and in turn that this extra activation can affect technique and performance. Neurological research, nearly all of it based on case studies, has failed to find evidence of dystonia (pathological muscle spasms) or other neurological illness in yips sufferers.

Crossing these research categories are other studies that have looked at interventions, including but not limited to, the use of drugs that are usually used in the treatment of Parkinson's Disease, which proved effective; a form of alternative therapy known as the "emotional freedom technique", which also supposedly helped; and acupuncture (also apparently helpful). But crucially, this intervention research has all been based on case studies (that is the stories of one or two people, rather than properly controlled trials) – in other words, this is the kind of evidence that would carry little weight were it used to support treatments for more serious medical conditions.

Part of the reason there's so much inconsistency in the research on the causes of the yips, explain Clarke and his team, is that until recently nearly all studies failed to distinguish between sports players who experienced purely physical yips in the absence of any psychological aspect, and those who experience the converse – choking mentally, but without the physical jerks or other uncontrolled movements (referred to as type 1 and type 2 yips). Clarke's team say future research should also recognise a third group (type 3), who experience the physical element of the yips and the psychological element.

Another limitation of the research conducted on the yips to date is that it has all been exclusively cross-sectional in design, making it very difficult to establish whether, for example, stress and performance-anxiety causes the yips, or if instead, experiencing the yips prompts performance anxiety. Clarke and his colleagues conclude that we need more research into the yips, especially longitudinal in design and in sports besides golf. The yips – a topic which is attracting increased interest from sports psychologists and scientists, but which remains in "its infancy".